Awareness of plaque-induced gingivitis during fixed orthodontic treatment due to oral hygiene practices among Malaysian university students

Document Type : Original Article

Authors

1 Department of Preclinical Sciences, Faculty of Dentistry, MAHSA University, Selangor, Malaysia

2 School of Dentistry, Management and Science University, Selangor, Malaysia

3 Health Research Centre, Jazan University, Jazan, Saudi Arabia

4 Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia

5 Animal Production Department, College of Food and Agriculture Sciences, King Saud University, Riyadh, Saudi Arabia

6 Department of Medical Sciences, School of Medical and Life Sciences, Sunway University, Selangor, Malaysia

7 School of Biology, Faculty of Applied Sciences, Universiti Teknologi MARA, Shah Alam, Malaysia

8 Early Clinical Exposure and Professional Personal Development, Faculty of Medicine, MAHSA University Selangor, Selangor, Malaysia

Abstract

Background: Fixed orthodontic treatment (FOT) is instrumental in addressing dental and skeletal discrepancies; however, it serves as a local predisposing factor for plaque-induced gingivitis. The placement of the fixed orthodontic appliance (FOA) components exacerbates plaque accumulation in the adjacent gingival sulcus, around bracket perimeters and beneath archwires. The mechanical hindrance posed by FOA complicates routine oral hygiene practices, thereby predisposing individuals to plaque-induced gingivitis.
This study aimed to evaluate the awareness of periodontal health; as well as the knowledge and attitude of oral hygiene education (OHE) among Malaysian university students undergoing FOT.
Methods: The study also compared the routine oral hygiene practices and OHE knowledge across different durations of FOT and between dental and non-dental students with FOA. A questionnaire-based study was conducted among 394 Malaysian university students (mean age=23.12 years, σ=3.01), all of whom had ceramic or metal brackets in either conventional or self-ligating systems. The average duration of orthodontic treatment was 16.61 months (σ=7.73).
Results: The results indicated a moderate awareness of periodontal health (mean score: 1.33, σ=0.28). Statistically significant differences were observed between the FOT duration and OHE knowledge and attitudes (P<0.001); as well as between dental students with FOA and their adherence to routine oral hygiene practices (P<0.01).
Conclusion: In conclusion, Malaysian university students undergoing FOT demonstrated moderate awareness of periodontal health and OHE knowledge. These findings emphasize the necessity of reinforcing oral hygiene education, particularly for non-dental students, to mitigate the oral health challenges associated with FOA.

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1. World Health Organization (WHO). Oral Health. WHO;
2025. Available from: https://www.who.int/news-room/factsheets/detail/oral-health.
2. Darby ML. Procedures Manual to Accompany Dental
Hygiene: Theory and Practice. Saint Louis, Missouri: Saunders
Elsevier; 2010.
3. Shroff B. Biology of Orthodontic Tooth Movement: Current
Concepts and Applications in Orthodontic Practice. Springer;
2016. doi: 10.1007/978-3-319-26609-1.
4. Blicher B, Joshipura K, Eke P. Validation of self-reported
periodontal disease: a systematic review. J Dent Res.
2005;84(10):881-90. doi: 10.1177/154405910508401003.
5. Newman MG, Takei H, Klokkevold PR, Carranza FA.
Newman and Carranza’s Clinical Periodontology. Saunders
Elsevier; 2018.
6. Shivakumar K, Chandu G, Shafiulla M. Severity of malocclusion
and orthodontic treatment needs among 12- to 15-year-old
school children of Davangere district, Karnataka, India. Eur J
Dent. 2010;4(3):298-307. doi: 10.1055/s-0039-1697843.
7. Bollen AM, Cunha-Cruz J, Bakko DW, Huang GJ, Hujoel PP.
The effects of orthodontic therapy on periodontal health: a
systematic review of controlled evidence. J Am Dent Assoc.
2008;139(4):413-22. doi: 10.14219/jada.archive.2008.0184.
8. Lara-Carrillo E, Millán-Hernández XA, Salmerón-Valdéz EN,
Scougall-Vilchis RJ, Medina-Solís CE, Toral-Rizo VH. Fluoride
releasing dental materials used in orthodontics: literature
review. J Oral Health Oral Epidemiol. 2018;7(2):52-8. doi:
10.22122/johoe.v7i2.334.
9. Ebadifar A, Shafazand MH, Seifi M. Arch dimensional changes
following orthodontic treatment with extraction of four first
premolars. J Oral Health Oral Epidemiol. 2016;5(2):84-9.
10. Zachrisson BU, Zachrisson S. Gingival condition associated
with partial orthodontic treatment. Acta Odontol Scand.
1972;30(1):127-36. doi: 10.3109/00016357209004597.
11. Boyd RL. Longitudinal evaluation of a system for
selfmonitoring plaque control effectiveness in orthodontic
patients. J Clin Periodontol. 1983;10(4):380-8. doi:
10.1111/j.1600-051x.1983.tb01287.x.
12. Moshkelgosha V, Golkari A. An evaluation of willingness to
pay for orthodontic treatments in patients of Shiraz dental
school clinic. J Oral Health Oral Epidemiol. 2013;2(1):35-43.
13. Alhaija ESA, Al-Saif EM, Taani DQ. Periodontal health
knowledge and awareness among subjects with fixed
orthodontic appliance. Dental Press J Orthod. 2018;23(5):40.
e1-.e9. doi: 10.1590/2177-6709.23.5.40.e1-9.onl.
14. Baheti M, Toshniwal N. Survey on oral hygiene protocols
among orthodontic correction-seeking individuals. J Educ
Ethics Dent. 2015;5(1):8. doi: 10.4103/0974-7761.178020.
15. Azodo CC, Umoh AO. Periodontal disease awareness and
knowledge among Nigerian primary school teachers. Ann
Med Health Sci Res. 2015;5(5):340-7. doi: 10.4103/2141-
9248.165257.